Wisdom Teeth

What are Wisdom Teeth?

Wisdom teeth or Third Molars are the back corner teeth which usually erupt into your mouth round the age of 17 to 25.

The term probably dates back to the Latin term dens sapientiae which translates to wise teeth - however the wise is used in an ironic sense.

The term arrives from the fact that as they come through the person is probably at the age where they are considered (rightly or wrongly) to be wise.

People can have up to four wisdom teeth, one in each corner of the mouth. However, a few people are missing some if not all of them.

It is said that due to our evolution the human jaw bone is getting smaller and as a result there is not enough room for the teeth to fully come through.

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en.wikipedia.org

This x-ray shows a person with potentially troublesome wisdom teeth. The darker area around the lower teeth indicates a long term infection.

It is likely that this person’s lower wisdom teeth have partially come through. The right hand side is probably more painful as the top tooth will be biting down on the gum covering the lower tooth.

The wisdom tooth on the left side is high up, it may not have come through and by itself would be fine to leave. The lower left tooth has an area of infection round it and is on a horizontal angle. This would be a difficult extraction

Should my wisdom teeth be extracted?

(This extract has been copied from the American Association of Oral Surgeons websitehttp://myoms.org/procedures/wisdom-teeth-management)

Wisdom teeth may not need to be extracted if they grow in completely and are functional, painless, cavity-free, disease-free and in a hygienic environment with healthy gum tissue. They do, however, require regular, professional cleaning, annual check-ups and periodic X-rays to monitor for any changes.

When a tooth doesn't fully grow in, it's "impacted"–usually unable to break through the gums because there isn't enough room. 90% of people have at least one impacted wisdom tooth.

An impacted wisdom tooth can damage neighbouring teeth or become infected. Because it's in an area that’s hard to clean, it can also invite bacteria that lead to gum disease. Oral bacteria can also travel through your bloodstream and lead to infections and illnesses that affect your heart, kidneys and other organs. In some cases, a cyst or tumour can form around the base of the impacted tooth, which can lead to more serious problems as it hollows out the jaw and damages surrounding nerves, teeth and other parts of your mouth and face.

Generally, wisdom teeth should be surgically removed when there are:

Infections and/or periodontal (gum) disease

Cavities that can’t be restored

Cysts, tumours or other pathologies

Damage to neighbouring teeth

Are the extractions difficult?

Obviously everyone is different. The extraction of upper wisdom teeth can be extremely easy. However, some lower extractions can be extremely difficult and it is often necessary to refer you to a specialist.

The degree of difficulty is dependent on a number of factors

• How far the tooth has erupted

• Can the tooth be accessed

• The shape of the roots

• How close the nerves are

Often the teeth will be simply extracted with the use of forceps. However, for difficult extractions the teeth need their roots divided and surrounding bone removed to enable them to be extracted

Are there any risks to wisdom teeth extraction?

Yes.

For upper teeth the roots can be situated very close to the air sinus. In rare circumstances a hole can be formed with the extraction.

For lower teeth

• The inferior dental nerve can be damaged- this nerve supplies sensation to the lower teeth and lip

• The lingual nerve can be damaged- this nerve supplies sensation to one side of the tongue

• The back of the tooth in front of the wisdom tooth can be damaged due to the loss of supporting bone

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This x-ray shows a lower right wisdom tooth.

The root of the tooth runs down to the inferior dental nerve. Also notice how close the back of the tooth in front of it is

Can I get knocked out to get my teeth taken out?

Yes. For difficult extractions (ones which require a surgical approach) your dentist may refer you on to a specialist who can offer General Anaesthetic or alternatively if the extractions are straight forward but you do not want to be conscious during the procedure the dentist can offer intra venous (IV) sedation.

Sedation is when some relaxing drugs are administered. The work gets done, afterwards while feeling groggy you do not remember what has happened

Do wisdom teeth cause my front teeth to crowd?

Our teeth are programmed to slowly move towards the front of our mouths. This is because our ancestors were more likely to get a few teeth knocked out while hunting woolly mammoths and the diet which they consumed was also more course. As a result of this their teeth would be worn down in height and width.

Studies are a bit inconclusive they show our teeth crowd any way, but does having the wisdom teeth increase the rate?